Challenges in the Management of COVID-19 Patients with Metabolic Syndrome with Special Emphasis on Gender and Age - A Review

Author(s): Arunima Chaudhuri1, Suhrita Paul2, Tapas Ghosh3

The corona virus disease-19 (Covid-19) pandemic has put human civilization into
a huge challenge, especially in the field of medicine in the management of patients
with co-morbidities. Health authorities across the world depend greatly on reliable
data to make major decisions and this is especially true during this global
pandemic. The present review was conducted to estimate the challenges in the
management of Covid-19 patients with metabolic syndrome with special emphasis
on gender and age.
Patients having pre-existing health conditions e.g., heart disease, diabetes are
at higher risk of morbidity and mortality due to COVID-19. According to the WHO
newsletter, COVID-19 has tragically claimed more than 1.5 million lives. The
burden of obesity across the world has nearly tripled since 1975. In 2016, 1.9
billion adults, were overweight; 650 million were obese; 13 % of the world's adult
population (11 % of males and 15 % of females) were obese in 2016. Obesity has
been observed to be a high-risk factor for COVID-19 severity. Severe acute
respiratory syndrome-corona virus-2 (SARS-CoV-2) targets the angiotensinconverting
enzyme 2 (ACE2) for cell entry and ACE2 is highly expressed in adipose
tissue. This suggests an important role for the tissue in determining COVID-19
disease severity in obese individuals.1-2 There has been an increase in death from
diabetes by 70 % globally between 2000 and 2019, and an 80 % rise in deaths
among males has been observed.
Metabolic syndrome comprises three or more of the following factors:
increased waist circumference; hypertriglyceridemia; elevated blood pressure;
reduced high-density lipoprotein cholesterol; hyperglycemia.1-2 Visceral fat is
known to produce higher concentrations of proinflammatory cytokines. These are
then released in the bloodstream. Release of proinflammatory markers in blood
stream may cause auto-amplifying cytokine production (“cytokine storms”) and
low-grade inflammation. Cytokine storm and low-grade inflammation can
contribute to worsening of COVID-19 patients with obesity. Components of
metabolic syndrome such as hypertension, type 2 diabetes mellitus (T2DM), and
obesity are highly prevalent among the general population and have been
observed to significantly increase the risk of hospitalization and mortality in
COVID-19 patients.1-2